2017 BLUE1647 Youth Summer Coding Bootcamps Application
Our full-time Youth Summer Coding Bootcamp classes are intensive, immersive instruction held at BLUE1647 Headquarters, an impactful entrepreneurship & technology innovation center, located at 2150 S. Canalport Ave, Chicago, IL. 60608.

The age range is 7-17. All students build digital products and create a digital portfolio. Our new scheduling format allows for any student, that is interested in two different subject areas, to be able to participate in different classes.

Duration:
Session 1 - IN PROGRESS.
Session 2 - 4-weeks, July 24th-August 18th. Monday - Friday. Students should bring a lunch.

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Session 2:
4-weeks: July 24th-August 18th
Monday - Friday
Students should bring a lunch.

MORNING COHORTS: 9:00 am to 1:00 pm
- Minecraft ($500)
- Robotics ($500)--------------(Ages 10+)

AFTERNOON COHORTS: 1:30 pm to 5:30 pm
- Minecraft ($500)
- Arduino Engineering ($500)-------------(Ages 11+)
- Web Development ($500)

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PART-TIME SATURDAY PROGRAMS ARE:
21st Century Youth Project's Intro to Web Development & Intro to Minecraft. Apply visit Blue1647.com & click "Apply" on 21st Century Youth Project)

STUDENT INFORMATION
Student's First & Last Name
Your answer
Student's Age
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Gender
Ethnicity
Choose all that apply
Required
What grade are you currently in?
What school does your student attend? Please list full school name.
Your answer
Session 2, 4-weeks: July 24th-August 18th
Choose 1 OR 3 classes to enroll in. Each class is $500. Night classes are $300.
What MORNING Class would you like to enroll in (9:00a-1:00p)
What AFTERNOON Class would you like to enroll in (1:30pm-5:30pm)
I agree for photos and video to be taken of my student to chronicle the experience.
Please let us know of accommodations needed or any learning needs your child may have in order for us to serve your child better.
Your answer
PARENT/GUARDIAN INFORMATION
Parent/Guardian First & Last Name
Your answer
Parent/Guardian Email (this is where we will contact you, please proof read to make sure this is input correctly)
Your answer
Parent(s)/Guardian(s) Phone Number
Your answer
Home Address
Your answer
City
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State
Your answer
Zip Code
Your answer
Parent(s)/Guardian(s) Occupation(s)
Your answer
How did you hear about our youth summer coding bootcamp?
Your answer
The responses in this application are truthful. If selected, I will abide by the rules and expectations of the program and trainers.
Emergency Contact's First and Last Name
Your answer
Emergency Contact Relation
Your answer
Emergency Contact Phone Number
Your answer
How will your child get to/from the classes?
Your answer
Please make sure your student arrives at BLUE1647 by the time class starts and will leave when the designated class ends.
I understand Full-time classes are $500 (approx. $125 per week of training)
Submitting your application signifies that you have read and agree to the Privacy Policy linked here: https://hackpad.com/ep/pad/static/MYozGlvEGm7
I understand once I submit payment, there will be no refunds. Since there's no refunds with costs going toward instructor preparation, software and equipment, be sure your student is able to attend before submitting payment.
I understand if payment is not made, there's a chance the class may reach capacity, and my student might not be enrolled.
My child, whose name is listed above, has permission to participate in BLUE1647. Indemnity and Waiver of Claim: I acknowledge that as a condition of the Student participating in any of the programs or activities, I agree to indemnify and hold harmless BLUE1647, its volunteers, and the owners of the place where the program/activity is being held, from any liability arising out of the above mentioned program or activity. Photographic Image Use: I do give permission for photos or videos to be captured and posted on BLUE1647 sites, approved partner websites, or for press related purposes. No last names will be used on BLUE1647 website. I understand that typing my name above constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance.
I understand I will be contacted within 1-2 days.
Due to the volume of emails, we will email you, please know your application will be received.
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